Voluntary sterilization: USA and China
Presl, J.
Ceskoslovenska Gynekologie 43(8): 626
1978
ISSN/ISBN: 0374-6852 PMID: 688441 Document Number: 449182
At the present time, there are in the U.S. 9.5 million married people and 2 million single people who have undergone voluntary surgical sterilization. That means that in 29% of married couples, one of the partners has been surgically sterilized. Women are more frequently sterilized than men, in the ratio of about 8:1. In 60% of the cases, women are sterilized after delivery, and in 40% of the cases the procedure is carried out at another time. If present trends continue, voluntary sterilization will soon replace birth control pills as the most frequently used contraceptive method in the U.S. In China, about 34 million married people have been sterilized. This represents about 20% of all married couples. In the Shaghai area, about 30% of women in the child-bearing ages have been sterilized; one Shaghai hospital performed 4000 sterilizations to 3000 deliveries in 1976. In China, the government dicted "norm" is 2 children, and couples experience considerable social pressure to limit their families to this size. The male method of surgical sterilization is vasectomy, while conventional laparotomy, mini-laparotomy, colpotomy, laparoscopy, and culdoscopy can be performed in women. The drawback of surgical sterilization is its relative irreversability. In India, 1% of sterilized women and 4% of sterilized men have had their fertility restored. Furthermore, a study of British sterilized women showed that 3.3-4.6% of them regretted their decision to be sterilized. This study showed that divorce, the death of a child, a change in opinion, and sexual dysfunction were the most common reasons women had for wanting reversals of surgical sterilization. Tubal ligation is theoretically reversible in 10 to 50% of the cases. Success of the reversal procedure depends largely on the skill of the surgeon and the amount of damaged tube. New methods for occluding the tube, namely the Yoon ring, the fallope ring, and the Hulka-Clemens clip damage the least amount of tube and therefore offer the best hope for reversal.